Accelerated experiential dynamic psychotherapy (AEDP)

Core affect3

Built-in, bodily, universal emotional experiences, such as categorical emotions and attachment strivings, that are adaptive once fully processed.

The triangle of experience3

A map from short-term dynamic therapy: defences (D) and inhibiting feelings such as anxiety (A) block access to core affect (E). It shows where the client is right now.

Transformance3

The overarching motivational force towards positive change; even in the first state, glimmers of it show up beside the defences.

Undoing aloneness2

Overwhelming emotion faced alone gets blocked; felt in the presence of a "true other", it can be processed and healed.

Transformational affects3

Change itself brings feelings: relief, pride, grief for the self, gratitude, and trembling excitement. AEDP names six kinds and works with them.

Core emotion (E)3

Illustration: a client talking about a father who never came to her school concerts starts to feel sadness rising, one of the core emotions the glossary lists (sadness, fear, anger, joy, excitement, disgust).

Anxiety (A)3

Illustration: as the sadness rises her chest tightens and she feels a wave of nervousness: the inhibitory affect at the top of the triangle, which the glossary says increases when emotion feels overwhelming.

Defence (D)3

Illustration: she then laughs, says "Anyway, it was ages ago" and changes the subject: a strategy "used to avoid painful emotions", the defence corner.

Working back down the triangle3

Illustration: the therapist gently notes the shift and stays with her, the anxiety settles, and the sadness can be felt through to its end, as the glossary describes working with defences to reach adaptive emotion.

Metaprocessing questions3

After a shift the therapist asks things like "What's it like to feel this relief?", "What do you notice has changed?" and "What does this say about you?"

Post-breakthrough and mastery affects3

Relief, "feeling lighter, clearer, stronger"; and pride and joy, which come when fear and shame have been transformed.

Healing and tremulous affects3

Gratitude and tenderness toward the other and feeling moved; and fear mixed with excitement, curiosity, and "a feeling of positive vulnerability".

Core state3

The client reports calm, vitality and a sense of wellbeing, deeply in touch with themselves and the other person.

State 1: Stress and defence3

Defences, anxiety and dysregulated feeling, alongside first glimmers of resilience.

State 2: Processing core emotion3

Categorical emotions, attachment experiences and authentic self states are felt through in the body.

State 3: Metatherapeutic processing3

Client and therapist reflect on what just shifted, which brings its own transformational feelings.

State 4: Core state3

An open, calm state of contact with self and other, often with compassion, vitality and a coherent story of oneself.

A safe relationship2

The therapist co-creates a relationship that works as a safe haven and secure base for in-depth work with painful emotional and relational experience.

Tracking emerging feeling1

The therapist tracks emotion moment to moment so the client can experience previously blocked feelings in a regulated way, through to completion.

Metaprocessing3

When something good shifts, the therapist asks what it was like to experience it: the change becomes the focus of the work.

"Rigor without shame"2

Fosha's phrases for the stance include "existing in the heart and mind of the other" and being a "True Other".

Private-practice study5

62 self-referred adults in five countries had 16 AEDP sessions; large pre-post effects and mostly reliable change were reported.

Gains held a year later6

Follow-up found gains were kept at 6 and 12 months, with larger effects for people with more severe problems.

What was excluded2

Those studies excluded active suicidality, addiction, psychosis, bipolar disorder and current crises, so they say little about those groups.

Limits4

The AEDP studies are naturalistic, co-authored by the founder, and the randomised trials the Institute lists test affect-focused psychodynamic therapy generally, not AEDP.

The Transforming Power of Affect: A Model for Accelerated Change (Fosha, 2000)8

The book that first set out AEDP.

Undoing Aloneness and the Transformation of Suffering Into Flourishing: AEDP 2.0 (Fosha, 2021)1

The updated model, from the American Psychological Association; won an AAP Prose Award.

The Healing Power of Emotion (Fosha, Siegel and Solomon, eds., 2009)8

Links affective neuroscience and development to clinical practice.

Supervision Essentials for Accelerated Experiential Dynamic Psychotherapy (Fosha and Prenn, 2016)8

An APA book on supervising and learning AEDP.